Patterns of Intra-Articular Injection Use after Initiating the Treatment of Knee Osteoarthritis

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SCIENCE
Patterns of Intra-Articular Injection Use after Initiating the Treatment of Knee Osteoarthritis
Key Take-Away: 

Intra-articular corticosteroid injections provide the short-term decrease in osteoarthritis (OA) pain and can be recognized as an addition to main treatment for the relief of moderate to severe pain in people with OA. This study highlighted the performance of intra-articular injections in OA patients and found an association between patterns of injection use and patient-reported symptoms.

Knee OA accounts for more than 80% of the disease’s total burden. Intra-articular corticosteroid injections have shown to provide the short-term decrease in OA pain and is identified as an adjuvant to the main treatment for relieving moderate to severe pain in people with OA.

ABSTRACT: 
Background: 

Knee OA accounts for more than 80% of the disease’s total burden. Intra-articular corticosteroid injections have shown to provide the short-term decrease in OA pain and is identified as an adjuvant to the main treatment for relieving moderate to severe pain in people with OA.

The study aimed to describe and evaluate the longitudinal use of intra-articular injections after treatment initiation among adults with radiographically confirmed knee OA.

Methods: 

Using data from the Osteoarthritis Initiative (OAI), the study included participants with radiographically confirmed OA (Kellgren–Lawrence grade (K–L) ≥ 2) in ≥1 knee at baseline.

With 9 years of data, 412 participants newly initiating hyaluronic acid or corticosteroid injections with their index visit were identified. For each type of injection, socio-demographic and clinical characteristics were described by patterns of treatments (one-time use, switched, or continued injections). Multinomial logistic models estimated the extent to which patient-reported symptoms (post-initial injection and changes over time) were associated with patterns of injection use.

Results: 

Of those initiating injections, ∼19% switched, ∼21% continued injection type, and ∼60% did not report any additional injections.

For participants initiating corticosteroid injections, greater symptoms post-initial injection was associated with lower odds of continued use compared to one-time users (adjusted odds ratio (AOR) for Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain: 0.91; 95%, confidence interval (CI): 0.83 to 0.99; stiffness: 0.77; CI: 0.63 to 0.94; physical function: 0.97; CI: 0.94 to 1.00). Symptom changes over time (e.g., worsened or improved) were not associated with patterns of injections use.

Conclusion: 

After treatment initiation, the proportion of patients switching injection use and one-time users was substantial. Symptoms post-initial injection appear to be associated with patterns of injection use. The extent to which these patterns are an indication of lack of impact on patient-reported symptoms and should be explored further.

 

Source:

Osteoarthritis and Cartilage

Link to the source:

http://www.oarsijournal.com/article/S1063-4584(17)31043-9/fulltext?rss=yes

The original title of the article:

Patterns of intra-articular injection use after initiation of treatment in patients with knee osteoarthritis: data from the osteoarthritis initiative

Authors:

S.-H. Liu et al.

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